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The List

I am growing more grim about recovery for my mother. Physically, she has been rehydrated and her kidney function is returning to normal. All the medication issues are being addressed and physically she is stable. Yet, the crux of the matter hinges on her willingness to eat food and drink liquids. She has always been a finiky eater, but in the last year it has grown steadily worse, and in the last two weeks it has become almost starvation. On the last two or three days prior to my taking her to the hospital, she refused to consume more than 2-3 mouthfuls of food (perhaps 200 calories a day if lucky), and at most 1.5 cups of water a day. Neither quanitiy is appropriate to sustain life. She has been losing weight because she has become so adamant about not eating. A year ago, she weighed roughly 125 pounds and was thin but healthy. Last week she weighed 105 and today she weighed 101. She is killing herself by not drinking fluids nor eating food.

The lack of eating and drinking actually is the root cause of why she became hospitalized. The abnormalities in her kidney function and in her medication levels is a direct result of her refusal to eat or drink. Refusal is the wrong word.... "unwillingness to eat or drink by saying she has been eating and drinking plenty" is more accurate. For the last 7-10 weeks I have been literally begging her to eat and drink. I have been bringing her Dove Bars because 60% of the time she WILL eat them and get some calories (until last week when she started to refuse those as well). I know of no way to get her to change her mind and restart eating and drinking. If she does not start to eat and drink again, I know she will die soon. And it does not need to happen. If she would simply eat and drink she would again become stable and healthy enough to live her day-to-day lifestyle.

I am not really sure how to explain my mother's thoughts. She has and does have all the following symptoms within the last week:

1. Utter inablity to focus.
2. Extreme anger towards me and one other sibling.
3. Inability to understand (or lying?) time, day of week, etc.
4. Confusion about most subjects
5. Innaccurate belief that she has eaten and is eating sufficient food and drink.

I am at a loss on how to combat those inaccurate ideas about eating. I fear that her previous mental function may NOT return even as her kidney function is currently rebounding.

As a friend has written and asked me about the length of time I have been "caretaker" for my elderly mother, below I have cut and pasted from a document I have an abbreviated list of her history during the time I have been the designated "caretaker". I have this list (as well as a complete medication list) that I keep updated and in the glove box of each vehicle in the household. In this way, when she has an emergency need to go to the hospital, I have these lists (because they ALWAYS ask for the specific history EVEN THOUGH THEY HAVE IT ON THE COMPUTER AS WELL. The list is abbreviated a bit to keep out some of the precise and lengthy specific items, but is complete. Please recognize that even though a topic may only be a single line, it can involve weeks of concern before, weeks of stress during, and weeks of recovery following:

November 27, 1990
D&C (cervical cancer detected)

December 1990, January & February 1991
Radiation Treatments for cervical cancer

Feb. 18-22 1991
Radioactive Implant as final step in treatement for cervical cancer

1991 - ~2001
pap smears for followup

1991 - present
mammograms

April 1996
first bout of pneumonia

June 1996
blocked colon (emergency surgery) detected colon cancer

July 1996
reversal of colostomy and stoma after healing

September 1996 through February 1997
chemotherapy for colon cancer... five treatments in one week once every month for six months

1997 - present
various checks for colon cancer (colonoscopy, sigmoidoscopy, etc) every six months to one year

January 1998
bladder cancer detected

February 1998 - March 1998
Bladder Cancer Surgery... excised a section of the bladder and created a ~15-20% smaller bladder

June 1998 - present
cystoscopy every six months for check on bladder

January 2000
detection of partial blockages in heart

February 5, 2000
angioplasty with stints (two)

February 7, 2000
"heart attack" where the ventricles went into fibrilation

Spring 2000
Pacemaker/Defibrilator installed to protect against possible future rhythm problems with the ventricles

Continual....continued checkups for bladder, colon, cervix and now heart

~2001
colon problems due to adhesions... surgery to fix and also removal of severely scarred cervical region (full hysterectomy including ovaries removed)

~mid 2004
battery replaced in pacemaker/defibrilator

~2004
cataract surgery

2001 - present
several bouts with pneumonia

2004 - present
lung issues... lower lung volumes

2006 Gout

2006
currently in the hospital due to very high levels of potassium and Digitek medications due to severe dehydration from refusal to eat or drink

The list above is simply the essential details. The time, the effort, the worry, the sorrow inherent in each of the above is difficult to place a value upon.

My elderly mother gave up driving in 1988. I have been the primary (probably 97%) person responsible for taking her to hospitals, to appointments, and to vaccination clinics during this time.

I fear now that there will be no change in her condition except to worsen. I despise that the "reality" she believes... and hence her true reality... is one filled with hate for me. Her hate feels as if it negates that which was so very good. I do know it should not be thought of in that manner... but it is her current reality and hence it is also my current reality. I am having a very difficult time deailing with all of this. It makes me wish to cry nearly all the time. I miss her already, and yet she is alive.

PipeTobacco